Remote magnetic navigation for treatment of patients with atrial fibrillation

Abstract

Atrial fibrillation (AF) remains an important medical and social health problem occupying a leading position among all cardiac arrhythmias in clinical practice. AF increases overall mortality by 1.9 times and the risk of stroke by 5 times, leads to disability among the working-age population, and reduces the quality of life.Pulmonary veins isolation is the main approach in the treatment of AF symptomatic patients who are resistant to antiarrhythmic therapy. However, the use of this technique is associated with the need for long-term use of fluoroscopy and monitoring of the contact force of the ablation catheter with the heart tissue for an effective and safe exposure on the arrhythmia substrate. In addition, the complication rate can reach up to 5% even when using non-fluoroscopic navigation systems.Over the past decade, robotic magnetic navigation was established as a safe and effective technology in the treatment of patients with different cardiac arrhythmias. The advantages of this technology are the flexibility and mobility of the ablation catheter to reach difficult areas during ablation procedure, as well as high efficiency and safety, with a low fluoroscopy exposure time. This review analyses the current literature and documents the experience of using robotic magnetic navigation for the treatment of patients with different forms of AF. We conducted searches on Scopus, Web of Science databases and PubMed.The reviewed studies demonstrated that the use of robotic magnetic navigation is a safe and highly effective method of treating patients with AF. It also helps to reduce the time of fluoroscopy during ablation procedure.Received 26 August 2021. Revised 21 September 2021. Accepted 22 September 2021.Funding: This work was carried out within the framework of the state task of Ministry of Health of Russian Federation No. 121031300225-8.Conflict of interest: The authors declare no conflict of interest.Contribution of the authorsConception and study design: V.V. Beloborodov, A.G. Filippenko, A.B. RomanovData collection and analysis: V.V. Beloborodov, N.А. Yelemessov, E.V. Fisher, A.G. Filippenko, V.V. Shabanov, A.B. RomanovStatistical analysis: A.B. Romanov, I.L. MikheenkoDrafting the article: V.V. Beloborodov, A.G. Filippenko, A.B. RomanovCritical revision of the article: A.B. Romanov, I.L. Mikheenko, A.G. Filippenko, V.V. ShabanovFinal approval of the version to be published: V.V. Beloborodov, V.V. Shabanov, N.А. Yelemessov, A.G. Filippenko, I.L. Mikheenko, E.V. Fisher, A.B. Romanov